Complete blood count (CBC)

A complete blood count (CBC) is a blood test that measures the number and quality of red blood cellsred blood cellsA type of blood cell that carries oxygen to and carbon dioxide from tissues in the body. Red blood cells contain hemoglobin (a protein that carries oxygen and gives blood its red colour) and are made in the bone marrow. (RBCs or erythrocytes), white blood cellswhite blood cellsA type of blood cell that helps the body fight infection and diseases. (WBCs or leukocytes) and plateletsplateletsA type of blood cell that helps blood to clot. Platelets are made in the bone marrow. (thrombocytes).

A CBC includes the following information:

RBC count – the total number of RBCs

WBC count – the total number of WBCs

hemoglobinhemoglobinA protein found in red blood cells that carries oxygen and gives blood its red colour. (Hb or Hgb) level – the total amount of hemoglobin in the blood

hematocrithematocritThe proportion (by volume) of red blood cells in a blood sample. Hematocrit is a measure of both the number and size of red blood cells in the blood sample. (Hct) – the fraction of the blood made up of RBCs

mean corpuscular volume (MCV) – the average RBC size

mean corpuscular hemoglobin (MCH) – the average amount of hemoglobin per RBC

mean corpuscular hemoglobin concentration (MCHC) – the average concentration of hemoglobin per RBC

platelet count – the number of platelets

WBC differential count – the different types of WBCs expressed as a percentage

Why a CBC is done

A CBC may be done to:

provide information about a person’s general health

assess how well the blood-forming organs (for example, bone marrow and spleen) are functioning

check for anemia (a reduction in the number of healthy red blood cells)

check for infection

provide a baseline to compare with future CBCs during and after treatment

monitor the effects of therapy, especially therapies that can cause bone marrow suppression (a condition in which the bone marrow does not produce normal numbers of red blood cells, white blood cells and platelets)

How a CBC is done

A CBC test is usually done in a private laboratory or hospital laboratory. No special preparation is usually needed.

Blood is usually taken from a vein in the arm.

A tourniquet or elastic band is wrapped around the upper arm to apply pressure to the area and make the vein swell.

The person may be asked to open and close the fist to make the veins stand out more.

The skin is cleaned and disinfected.

A needle is inserted into the vein and a small amount of blood is removed.

The person will feel a prick or stinging sensation.

The sample is collected in a tube and labelled with the person’s name and other identifying information.

The tourniquet is removed and the needle is withdrawn.

Mild discomfort may be felt when the needle is withdrawn.

Pressure is applied to the area where the needle was inserted until bleeding stops.

A band aid may be applied.

The sample is sent to a laboratory to be analyzed by special machines, examined under a microscope or both.

Potential side effects

Potential side effects of having a CBC include:

bleeding

bruising

infection

What the results mean

Normal ranges may vary from person to person and laboratory to laboratory. Many factors can affect CBC results. An abnormal result will not necessarily identify the problem, so further investigation may be needed.

Common terminology to describe CBC results

Term

What it means

anemia

a reduction in the number of RBCs or hemoglobin content of RBCs

leukopenia

a reduction in the number of WBCs

leukocytosis

an increase in the number of WBCs

neutropenia

a decrease in the number of neutrophils

thrombocytopenia

a decrease in the number of platelets

thrombocytosis

an increase in the number of platelets

Abnormal CBC Values

Component

An increased value may be due to

A decreased value may be due to

WBC

infection

leukemia

some myeloproliferative disordersmyeloproliferative disordersAny of a group of diseases that affect the bone marrow and cause large numbers of abnormal red blood cells, white blood cells or platelets to build up in the bone marrow and blood.

some types of cancer (for example, bronchogenic carcinomabronchogenic carcinomaA cancerous (malignant) tumour that starts in the bronchi (the large tubes that connect the windpipe, or trachea, to each of the lungs).)

bone marrow disorders, such as leukemia or myelodysplastic syndrome (MDS)myelodysplastic syndrome (MDS)A group of disorders that affect the bone marrow so it does not produce enough healthy mature blood cells. People with MDS have low white blood cell counts, low platelet counts and increased monocytes in some cases. Signs and symptoms include fever, easy bruising and bleeding, infections, paleness a

anemia

immune system suppression

RBC

dehydration (such as from severe diarrhea)

kidney disease

some lung diseases

polycythemia vera (a myeloproliferative disorder)

anemia due to:

prolonged bleeding or blood loss (hemorrhage)

insufficient dietary intake of iron or certain vitamins

blood disorders

chronic disease

Hodgkin lymphoma and other lymphomas

blood related cancers, such as:

leukemia

mulitple myelomamulitple myelomaA type of cancer that starts in plasma cells (white blood cells that produce antibodies to help the body fight infection) in the bone marrow.

some myeloproliferative disorders

Platelets

prolonged bleeding or blood loss (hemorrhage)

iron deficiency anemia

infection (inflammation)

surgical removal of the spleen (splenectomy)

polycythemia vera (a myeloproliferative disorder)

some types of leukemia

bone marrow disease

diseases of the immune system

bacterial infection

viral infection

chemotherapy

radiation therapy

multiple blood transfusions

certain drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin or ibuprofen

Note: Not all factors or conditions that can increase or decrease blood counts are listed above. Only the main cancer-related ones have been included.

What happens if a change or abnormality is found

The doctor will decide if more tests, procedures, follow-up care or treatment are needed. Sometimes therapies or doses may need to be adjusted to avoid complications if blood cell counts are low.